Left Ventricular Dysfunction Clinical Trial
Official title:
A Phase II, Randomized, Controlled, Double-Blind Pilot Trial Evaluating the Safety and Effect of Administration of Bone Marrow Mononuclear Cells Two to Three Weeks Following Acute Myocardial Infarction
More than 1 million Americans suffer heart attacks each year. Although current treatments are able to stabilize the condition of the heart, none is able to restore heart function as it was prior to the heart attack. Adult stem cells, which are immature cells that can become many different types of cells, may offer a potential means of reversing or preventing permanent damage caused by a heart attack. Recent studies have shown promise in using adult stem cells from bone marrow to reverse damage to the heart muscle caused by a heart attack, but more research is needed to assess the safety and effectiveness of stem cell use and to discover the best time to administer treatment. This study will evaluate the safety and effectiveness of using adult stem cell infusions 2 to 3 weeks after a heart attack for improving heart function in people who have had a recent heart attack and a common procedure called a percutaneous coronary intervention (PCI).
Heart attacks are a leading cause of death for both men and women in the United States. A
heart attack occurs when blood flow to the heart is restricted, commonly due to a blood clot
that has formed in one of the coronary arteries. If the clot becomes large enough, blood
flow to the heart can be blocked almost completely and the heart muscle in that area can
suffer permanent injury or death. Although a PCI can be used to open up the blocked artery
and restore blood flow to the heart muscle, there may be a significant amount of heart
tissue that has been irreversibly damaged. Recent studies have shown that adult stem cells
from bone marrow may be able to improve heart function after a heart attack. These
specialized cells may have the ability to promote blood vessel growth, prevent cell death,
and transform themselves into a number of tissues, including muscle. After an acute heart
attack, a remodeling process is initiated in the heart in an attempt to compensate for
damaged areas. Consequently, the condition of the heart muscle several weeks after a heart
attack may differ considerably from the heart's condition during the acute setting. For some
patients, delaying the delivery of the stem cells until 2 to 3 weeks after a heart attack
may be better than initiating treatment during the acute phase. This study will evaluate the
safety and effectiveness of placing adult stem cells into injured heart muscle 2 to 3 weeks
after a heart attack for improving heart function in people who have had a recent heart
attack and a PCI.
Participation in this study will last 24 months. All participants will first undergo
baseline assessments that will include a medical history, a physical exam, an
electrocardiogram (ECG), blood draws, an echocardiogram, and a magnetic resonance imaging
(MRI) test. Participants will then be assigned randomly to receive stem cells or placebo
between 2 and 3 weeks after their heart attack. The morning of the stem cell or placebo
infusion, participants will undergo a blood draw and a bone marrow aspiration procedure of
the hip bone to collect the stem cells. Later the same day, either stem cells or placebo
will be infused through a catheter and into the damaged area of the heart.
For the first 24 hours after the infusion, participants will be asked to wear a small ECG
machine called a Holter monitor. Participants will also be asked to record their temperature
twice a day for a month after the infusion. Participants will return for follow-up visits at
Months 1, 3, 6, 12, and 24 and will repeat many of the baseline assessments.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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